| NPI | 1982076097 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY BRADLEY Owner / Dentist 928-897-9946 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AZ 7614) |
| Enumeration Date | 2015-10-28 |
| Last Update Date | 2015-10-28 |